Endocrine Abstracts

Introduction: Type 2 diabetes mellitus (T2DM) is an independent risk factor for uric acid nephrolithiasis and obesity augments this risk. We studied 25 T2DM patients to assess the risk factors for uric acid nephrolithiasis and their relation with metabolic syndrome.

Methods: In this cross-sectional study, 25 patients of T2DM were included and examined for components of metabolic syndrome. A single 24 h urine sample was analyzed for uric acid, creatinine and protein. Fasting urine pH was checked from first void morning sample. Fasting serum sample was analyzed for HbA1c, glucose, creatinine, uric acid and lipid profile. Patients with past history of nephrolithiasis and significant hepatic or renal disease were excluded.

Results: The mean age of the participants was 51±8.5 year and there were 16 females and 9 males. Mean body mass index (BMI) was 27.3±4.3 kg/m² and waist circumference was 90.8±7.8 cm. Urinalysis reveals mean uric acid excretion of 595±133 mg/24 h and fasting urine pH of 5.6±0.4. Fasting urine pH correlated inversely with the body weight, BMI and LDL-cholesterol (P<0.05). Total volume showed inverse correlation with age and disease duration and positively with body weight and BMI. Uric acid excretion did not correlate with the components of metabolic syndrome.

Conclusion: Our preliminary data demonstrate that the main risk factor for uric acid nephrolithiasis in patients with T2DM is low urine pH. Higher BMI further accentuates this risk. Further data from more number of patients is necessary to confirm these findings.